During and prior to surgery, a patient is often manipulated manually to properly position various parts of his or her body to facilitate the performance of certain medical procedures. For example, a patient's head and neck may be manipulated to facilitate the insertion of an endotracheal tube for intubation, a patient's head and shoulders may be manipulated and positioned for a thyroid operation, and a patient's torso may be manipulated to better present a breast for examination and surgery. The proper manipulation and/or placement of the patient's body is often necessary to prevent brachial plexus injury as in kidney or hip surgery.
Endotracheal intubation requires the insertion of a flexible tube through the oral cavity (or sometimes nasal cavity), the oropharynx, the glottis and into the trachea. Safe and successful intubation requires controlled insertion of the endotraeheal tube so that the tube is introduced through the glottis of the larynx without damaging the teeth or surrounding tissues such as oropharynx, epiglottis, vocal cords or laryngeal cartilages. It is desirable that the practitioner inserting the tube has a clear view of the glottis and vocal cords to guide the tube into the trachea successfully and without injury to the patient. It is sometimes difficult or even not possible to obtain a clear view of the glottis, so it is desirable that optimal positioning of the laryngoscope blade and the patient's head be attained for increasing the success of endotracheal intubation. The intubation process typically requires extending the head of the patient to facilitate insertion of the laryngoscope blade into the mouth. With the laryngoscope blade in place against the tongue of the patient, the practitioner uses the laryngoscope to lift the tongue and frequently lift the patient's head with the blade to expose the glottis into view.
There are several problems with the conventional manner in which endotracheal intubation is performed. Because the blade is used to lift and position the patient's head, there is a certain likelihood of trauma to the soft tissues of the patient's mouth, pharynx, vocal cords, laryngeal cartilages and to the teeth, leading to bleeding, sore throat, hoarseness or dislodgment or breakage of teeth. Furthermore, because the practitioner typically uses his/her weaker non-dominant hand to hold the laryngoscope handle and insert the laryngoscope blade so that the dominant hand can be used to insert the endotracheal tube, the practitioner often has difficulty lifting, supporting and manipulating the patient's head with the weaker non-dominant arm and hand. Therefore, in a substantial percentage of cases, the practitioner is required to request and wait for another person's, typically a nurse's, assistance in lifting the patient's head into optimal position. This person also frequently is asked to apply pressure on the front part of the neck over the cricoid cartilage for better visualization of the glottis and to prevent aspiration of gastric contents which can cause pneumonia, lung abscesses or even death. The necessity of calling for and requiring an assistant causes delay and interferes with the nurse's performance of his/her tasks in getting the surgical procedure underway.
In many other procedures, such as surgery in which the patient is required to assume and maintain a lateral position, such as kidney or hip surgery, the patient's axillary neurovascular structures may become damaged irreparably if the patient's body weight is improperly supported. During other surgical procedures such as thyroid gland surgery and anterior cervical spine surgery, the patient, lying in a supine position, must be positioned to provide better access to the anterior neck region. It is a common practice for medical personnel to simply roll up a towel or some other soft padding and place it under the patient. However, these rolls are often not optimal in size for safe positioning of the patient. Further, these towel rolls and padding cannot be easily adjusted to vary the height or orientation to modify the patient's position intraoperatively. Many other procedures may require the patient to assume a prescribed position in order to minimize risks or improve the performance of the procedures.